title: Effects of low-dose mirtazapine on driving performance in healthy volunteers.
abstract: OBJECTIVE
  This study aimed to assess whether a lower initial dose of mirtazapine can lessen the harmful effect on driving performance or not in a double-blinded, placebo-controlled crossover trial.
  
  
  METHODS
  Thirteen healthy men received 8 days of continuous nocturnal doses of mirtazapine at 7.5 mg or 15 mg, or placebo. At baseline and on days 2 and 9, subjects performed three driving tasks (road-tracking, car-following, and harsh-braking tasks) using a driving simulator and a Continuous Performance Test. Stanford Sleepiness Scale (SSS) scores were also assessed. In the mirtazapine 7.5 mg series, 15 mg of mirtazapine was additionally administered on day 9, followed by all the same assessments on day 10.
  
  
  RESULTS
  Mirtazapine 7.5 mg had no significant effects on any tasks except for SSS compared with placebo. Mirtazapine 15 mg impaired road-tracking task and SSS. The increase in mirtazapine dose also had no significant effects on any tasks compared with those before dose increase.
  
  
  CONCLUSIONS
  Mirtazapine 7.5 mg did not cause driving impairment compared with mirtazapine 15 mg, while both doses of mirtazapine produced subjective somnolence. The increase in mirtazapine had no detrimental effects on psychomotor performance. Initial low-dose mirtazapine may be safer for automobile driving than the normal starting dose.
authors.affiliation: Department of Psychiatry, Nagoya University, Graduate School of Medicine, Nagoya, Aichi, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Iwamoto
authors.forename: Naoko
authors.initials: N
authors.lastname: Kawano
authors.forename: Kazumi
authors.initials: K
authors.lastname: Sasada
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Kohmura
authors.forename: Maeri
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Ebe
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Noda
authors.forename: Norio
authors.initials: N
authors.lastname: Ozaki
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage; D000328:Adult; D001334:Automobile Driving / Q000523:psychology; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D064368:Healthy Volunteers / Q000523:psychology; D006801:Humans; D008297:Male; D008803:Mianserin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008875:Middle Aged; D000078785:Mirtazapine; D011597:Psychomotor Performance / Q000187:drug effects* / Q000502:physiology; D011930:Reaction Time / Q000187:drug effects / Q000502:physiology
chemical_list: D000317:Adrenergic alpha-Antagonists; D008803:Mianserin; D000078785:Mirtazapine
keywords: cognitive function; driving performance; mirtazapine; sedation; starting dose